Bad Scan but no rush? Lung nodule - update

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Sunwaterandsky
Posts: 155
Joined: Fri Oct 14, 2011 10:06 am
Location: Hong Kong

Bad Scan but no rush? Lung nodule - update

Postby Sunwaterandsky » Mon Jun 12, 2017 9:34 am

I went in for my 5 year post chemo visit to find that there were some concerning findings on my most recent CT scan. I went from feeling on top of the world to worrying constantly. I have a 1.5 cm nodule on my lung with spiculated margin and some cavitation. My "benign" adrenal tumour is now 3.8 cm big (up from 2.5) and I have small lesions on my thyroid. It's all very confusing though, the oncologist sent me to the thoracic surgeon who seems relaxed and says I can wait a month for my PET scan and possible biopsy (I am scheduled to fly back home to Canada for a month). He sends me to the Surgeon for the Adrenal tumour - that is next week. I am stressed and calm all at the same time.

The thoracic guy seems concerned but says that the lung thingy is small and slow growing so there is no rush. I know that this is nothing compared to what other forum members have gone through but I value your opinions.

Should I be cancelling my trip home and getting the PET scan now? The thoracic guys says I can't fly for quiet a while after a biopsy.

Advice from experts?
Last edited by Sunwaterandsky on Tue Aug 08, 2017 9:39 am, edited 1 time in total.
Stage 3B colon cancer at 47 years of age
small benign tumour on Rt adrenal gland
Xelox started 28/10/2011 finished 04/2012
CT scan clear 16/2012
Colonoscopy Clear October 2012
CT scan clear January 2013
CT scan Jan 2016 - small 9mm lung nodule
CT scan April 2017 - lung nodule 1.5 cm, bilateral thyroid lesions

stu
Posts: 567
Joined: Sat Aug 17, 2013 5:46 pm

Re: Bad Scan but no rush? Lung nodule

Postby stu » Mon Jun 12, 2017 11:29 am

Hi,
Really sorry to hear your news. I think with your health care system you are able to get very prompt scans and results. Here in the UK we don't have that type of speed . A lung nodule was detected in Late October for my mum her meeting with the surgeon took place after Christmas and was removed early Jan. We relaxed and enjoyed Christmas as the lung was slow growing. It can take weeks just to get results. There are many , many positives with our system but speed is not always one. We are used to it.
It's up to you in the end but you could have everything lined up for when you come back.
Just to share and reassure,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection

User avatar
Sunwaterandsky
Posts: 155
Joined: Fri Oct 14, 2011 10:06 am
Location: Hong Kong

Re: Bad Scan but no rush? Lung nodule

Postby Sunwaterandsky » Tue Jun 13, 2017 7:43 am

Thanks Stu. Yes, I am lucky. With a combination of public health and insurance, I have good access to health services.
Stage 3B colon cancer at 47 years of age
small benign tumour on Rt adrenal gland
Xelox started 28/10/2011 finished 04/2012
CT scan clear 16/2012
Colonoscopy Clear October 2012
CT scan clear January 2013
CT scan Jan 2016 - small 9mm lung nodule
CT scan April 2017 - lung nodule 1.5 cm, bilateral thyroid lesions

DanInMN
Posts: 86
Joined: Mon Apr 02, 2012 11:18 pm

Re: Bad Scan but no rush? Lung nodule

Postby DanInMN » Wed Jun 14, 2017 9:14 am

I was recently in a similar situation. Five years out and a growing nodule in my lung. I personally pushed to have the biopsy done quickly. I can't say this mattered medically. The nodule was very slow growing. It was something I personally wanted, as I hate sitting with uncertainty. We have enough of that. I know how you feel, being all ready to celebrate the 5 year mark and suddenly being back in the game. For me, the nodule turned out to be a met from the colon cancer, moving me from stage III to IV. My understanding is this is unusual, and most nodules turn out to be benign. I will be hoping this is the case for you.

I'm sorry you find yourself in this position. I think your Dr. is probably right that a month won't make a difference. After all, it took 5 years for things to get where they are today. Just keep your psychological needs in mind.
Dan - Male - Age 41
3/5/2012 - Colonoscopy - dx: sigmoid colon cancer
3/29/2012 - Colon Resection - growth through wall, 1 of 23 nodes, 4 tumor deposits - dx: Stage 3b
5/7/2012 - Begin Folfox
10/10/12 Finish Folfox
10/22/12 CT scan = NED
4/17/17 Lung nodule discovered to be colorecretal cancer met
5/12/17 Met removed

User avatar
Sunwaterandsky
Posts: 155
Joined: Fri Oct 14, 2011 10:06 am
Location: Hong Kong

Re: Bad Scan but no rush? Lung nodule

Postby Sunwaterandsky » Wed Jun 14, 2017 10:03 am

Hi Dan,

I am sorry to hear that. I know how we cherish every day that we are cancer free.

Can I ask, what is the treatment plan now? I am assuming that mine is definitely cancer - met or new primary, based on the report. I am more concerned about what happens once it is identified.

cheers,
SWS
Stage 3B colon cancer at 47 years of age
small benign tumour on Rt adrenal gland
Xelox started 28/10/2011 finished 04/2012
CT scan clear 16/2012
Colonoscopy Clear October 2012
CT scan clear January 2013
CT scan Jan 2016 - small 9mm lung nodule
CT scan April 2017 - lung nodule 1.5 cm, bilateral thyroid lesions

DanInMN
Posts: 86
Joined: Mon Apr 02, 2012 11:18 pm

Re: Bad Scan but no rush? Lung nodule

Postby DanInMN » Wed Jun 14, 2017 11:08 am

Sunwaterandsky wrote:Hi Dan,

I am sorry to hear that. I know how we cherish every day that we are cancer free.

Can I ask, what is the treatment plan now? I am assuming that mine is definitely cancer - met or new primary, based on the report. I am more concerned about what happens once it is identified.

cheers,
SWS


Good question! After the biopsy was a PET scan, which showed no other activity. I had the met removed a few weeks ago (which was a breeze). I go see my oncologist in ~4 hours to talk about what comes next. When we last spoke, she showed me the recommendation flow chart from the National Cancer Something Something, which indicated there is not enough data to have a standard course of treatment when a solitary met appears 5 years out. She said we will have to decide whether to do another round of chemo or just observe. Whatever she recommends today, I intend to get a second opinion. I think the reality is that it is uncertain how likely more mets will appear, and whether the insurance provided by another round of chemo would outweigh the damage that chemo does. I've already lost a lot of feeling in my feet, for example.

I'll post more when I know more. Sorry I can't ease your mind. Isn't that always the story with this stuff?
Dan - Male - Age 41
3/5/2012 - Colonoscopy - dx: sigmoid colon cancer
3/29/2012 - Colon Resection - growth through wall, 1 of 23 nodes, 4 tumor deposits - dx: Stage 3b
5/7/2012 - Begin Folfox
10/10/12 Finish Folfox
10/22/12 CT scan = NED
4/17/17 Lung nodule discovered to be colorecretal cancer met
5/12/17 Met removed

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Sunwaterandsky
Posts: 155
Joined: Fri Oct 14, 2011 10:06 am
Location: Hong Kong

Re: Bad Scan but no rush? Lung nodule

Postby Sunwaterandsky » Thu Jun 15, 2017 5:01 am

Dan, I appreciate your efforts to ease my mind when your mind must be pretty full right now! I hope that the consultation today went well and that you have a plan that you are happy with.

Cheers,
SWS
Stage 3B colon cancer at 47 years of age
small benign tumour on Rt adrenal gland
Xelox started 28/10/2011 finished 04/2012
CT scan clear 16/2012
Colonoscopy Clear October 2012
CT scan clear January 2013
CT scan Jan 2016 - small 9mm lung nodule
CT scan April 2017 - lung nodule 1.5 cm, bilateral thyroid lesions

DanInMN
Posts: 86
Joined: Mon Apr 02, 2012 11:18 pm

Re: Bad Scan but no rush? Lung nodule

Postby DanInMN » Thu Jun 15, 2017 8:49 am

Well, I spoke with my oncologist. As expected, she reiterated that the data is thin for what the best approach is for someone in my position. She is recommending CT's every 3 months for a while, then every 6 months. She has also offered a couple chemo options if we feel the peace of mind is worth the effects of the treatment. I did not realize that the value of chemo drops off 6-8 weeks after surgery, so I need to make a decision relatively soon.

I'm setting up a second opinion with someone at the Mayo Clinic who is a bit more involved with the current research to see what he thinks.
Dan - Male - Age 41
3/5/2012 - Colonoscopy - dx: sigmoid colon cancer
3/29/2012 - Colon Resection - growth through wall, 1 of 23 nodes, 4 tumor deposits - dx: Stage 3b
5/7/2012 - Begin Folfox
10/10/12 Finish Folfox
10/22/12 CT scan = NED
4/17/17 Lung nodule discovered to be colorecretal cancer met
5/12/17 Met removed

Lee
Posts: 4974
Joined: Sun Apr 16, 2006 4:09 pm

Re: Bad Scan but no rush? Lung nodule

Postby Lee » Thu Jun 15, 2017 9:05 am

DanInMN wrote:
I'm setting up a second opinion with someone at the Mayo Clinic who is a bit more involved with the current research to see what he thinks.


SWS,

5 years out, that is rough. So very sorry this is happening to you. As Dan stated above, that is my advice to you, get a few opinions. The good news, there are options for dealing with this if they are in deed mets.

You will get beyond this,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

DanInMN
Posts: 86
Joined: Mon Apr 02, 2012 11:18 pm

Re: Bad Scan but no rush? Lung nodule

Postby DanInMN » Thu Jun 15, 2017 9:19 am

Sunwaterandsky,

Can I ask where the nodule is located in your lung? Based on my limited experience, I find it strange they are saying you can't fly for a while after a biopsy. Maybe it was because mine nodule was close to the rib cage, but the biopsy was quick and simple. I was partially knocked out to "relax" me, but not entirely as I needed to be able to follow instructions. I laid on my side in the CT scanner and the radiologist pushed a needle in maybe 5-6 times. There was basically no recovery time. I had a small bandage for a couple days and had to sleep off the anesthetic. Flying would have not been an issue even the next day.

Also, do you have any useful CEA results?
Dan - Male - Age 41
3/5/2012 - Colonoscopy - dx: sigmoid colon cancer
3/29/2012 - Colon Resection - growth through wall, 1 of 23 nodes, 4 tumor deposits - dx: Stage 3b
5/7/2012 - Begin Folfox
10/10/12 Finish Folfox
10/22/12 CT scan = NED
4/17/17 Lung nodule discovered to be colorecretal cancer met
5/12/17 Met removed

User avatar
Sunwaterandsky
Posts: 155
Joined: Fri Oct 14, 2011 10:06 am
Location: Hong Kong

Re: Bad Scan but no rush? Lung nodule

Postby Sunwaterandsky » Thu Jun 15, 2017 10:47 am

Hi Dan,

My nodule is in the right apical lung. He said that we need a more accurate scan to see exactly where it is and how easy it might be to access. My CEA is low but it was never a marker for me.

Apparently you run the risk of a lung collapse if you fly too soon after a biopsy or surgery. It is better to wait that to risk it.

A second opinion is a touchy thing here. If I have any surgery, that will top out my insurance and I'll have to rely on the public system. The public system is good, if not pretty, but there is little choice once you are in it. I am lucky that we have such a high population density that I can see any doctor within an hour's travel.

CT scans every 3 months and wait and see must feel a bit scary at this point. I hope that it goes well!

SWS
Stage 3B colon cancer at 47 years of age
small benign tumour on Rt adrenal gland
Xelox started 28/10/2011 finished 04/2012
CT scan clear 16/2012
Colonoscopy Clear October 2012
CT scan clear January 2013
CT scan Jan 2016 - small 9mm lung nodule
CT scan April 2017 - lung nodule 1.5 cm, bilateral thyroid lesions

User avatar
Sunwaterandsky
Posts: 155
Joined: Fri Oct 14, 2011 10:06 am
Location: Hong Kong

Re: Bad Scan but no rush? Lung nodule - update

Postby Sunwaterandsky » Tue Aug 08, 2017 9:47 am

So today was my big day. I had quite a journey to get my PET scan. The airline cancelled my flight, I had to reschedule my PET scan, the insurance approval had lapsed and so on..... but I got it and all was sorted in time.

Today I got my results. My little lung nodule is now 2cm big - 5 mm growth since last scan- and has a 2.5 uptake. The surgeon says that it is definitely not scarring and it growing. He is reluctant to label it cancer but once I labelled it cancer he said it was most likely. He says that it is more likely to be a new primary than a CC met. We'll find out soon enough.

I asked what the next step was and it's VATs. When I asked when... He said Monday! I was a bit freaked out by that and we settled on the 22nd. This will give me time to sort out some family support. I live in Hong Kong and the family is back in Canada.

This was what I expected and had researched. I have a good surgeon and I am lucky that I have had yearly scans and this was noticed. Although I guess you could argue that the yearly scans could have caused a new primary.......

Feeling positive knowing that this is going to be dealt with. I don't think I could have handled a "Let's wait and see" approach.

Cheers,
SWS
Stage 3B colon cancer at 47 years of age
small benign tumour on Rt adrenal gland
Xelox started 28/10/2011 finished 04/2012
CT scan clear 16/2012
Colonoscopy Clear October 2012
CT scan clear January 2013
CT scan Jan 2016 - small 9mm lung nodule
CT scan April 2017 - lung nodule 1.5 cm, bilateral thyroid lesions

ams5796
Posts: 2253
Joined: Fri Feb 06, 2009 10:07 am

Re: Bad Scan but no rush? Lung nodule - update

Postby ams5796 » Tue Aug 08, 2017 10:43 am

I'm curious as to why the surgeon thinks it's a new primary.

Either way, I agree I'd want to get rid of it and move on. I've had VATS a couple of times and it was very easy to get through.

I wish you the best.


Ann
Stage 3C (or 4?) Rectal Cancer 01/07
2/10 lung mets
3/11 VATS
6/11 VATS
7/13 lung met
2/14 SBRT
NED 8/14
5/17 scan and MRI found treated spine met

susie0915
Posts: 29
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter

Re: Bad Scan but no rush? Lung nodule - update

Postby susie0915 » Tue Aug 08, 2017 1:38 pm

I know the waiting is the worst. I had my l year ct scan last April and a 4mm lung nodule was found. I see a pulmonologist due to scarring and inflammation in the lungs discovered after chemo. Monitoring me for an auto immune disorder. My oncologist felt it was from the inflammation, not a met. My pulmonologist agreed that she didn't think it was a met but could be from the auto immune disorder, past infection and a new lung cancer. Both said it was much too small to biopsy so would have to wait and watch. I had a repeat ct scan in July and the nodule showed no change. No change or shrinkage is good so dr. will repeat again in 6 months. The waiting and doing nothing is awful as it is always in the back of your mind. When you are actively in treatment you at least feel like you are doing something. Very frustrating.

Susan
57 yr old mother of 3 adult children
5/15 Diagnosed with stage 2A rectal cancer
6/15 began 5 weeks of radiation/xeloda
9/15 Surgery to remove most of rectum
10/15 Bowel blockage. 3 1/2 weeks in hospital.
Dr. decided to reverse ileostomy since he
had to do surgery to repair blockage. c-diff infection
12/15 6 rounds of xelox
5/16 Clear CT lung scarring/inflammation
4/17 CT watching small 4mm lung nodule thinks is scar tissue
7/17 no change in 4mm lung nodule
Currently NED


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